MODULE 8 – PREVENTION
PRACTICE FOR ELDERLY
Dr. Swarup Ghosh (PT)
Assistant Professor, Swami Vivekanand University
BPT (WBUHS) MPT (Orthopaedics) (MMDU, Mullana, Ambala)
COMT | CPRS
WHAT IS GERIATRICS ?
• Ther term “Geriatrics” was derived from the Greek word ‘Geras’ meaning
old age and ‘Latrike’ meaning medical treatment
• The care of the aged is called “Geriatrics”
• The study of the physical and physiological changes which are incidental to
old age is clinical Gerontology
• AGEING: It is a progressive and generalized impairment of body function
resulting in loss of adaptive response to stress and increasing the risk of
age-related diseases
• People more than 60 years are considered elderly
• Old age is not a disease but a normal and inevitable biological phenomenon
WHAT IS PREVENTIVE GERIATRICS ?
• Preventive geriatrics is the art and science of preventing disease in the
geriatric population and promoting their health and efficiency
• Sir James Sterling comment that “You do not heal old age; you protect
it; you promote it; you extent it”
GOALS OF GERIATRIC CARE
• 1. Provide a safe and supportive environment
• 2. Restore and maintain the highest possible level of functional
capacity
• 3. Preserve individual autonomy
• 4, Maximize quality of life
• 5. Provide comfort and dignity for disabled and ill
• 6. Stabilize and delay the progression of chronic disease
• 7. Prevent acute medical illnesses, early detection and treatment
DEMOGRAPHY OF GERIATRIC
POPULATION
• Globally, the elder population constitute about 12% of the total
population of 7.3 billion. The number will be double by 2050,
reaching 2 billion and accounting for 22% of the global population
• In India too, the size and percentage of elderly population have been
increasing in the recent years and this trend is likely to continue in the
coming decades. The elderly population has increased from 77 million
in 2001 to 104 million in 2011 and by 2050 it is likely to increase by 3
times to reach around 300 million
COMMON PROBLEMS IN GERIATRIC
POPULATION
• 1. 🧠 Nervous System
• Cognitive Decline – memory loss, dementia, Alzheimer’s disease.
• Parkinson’s Disease – tremors, rigidity, postural instability.
• Sleep Disturbances – insomnia, fragmented sleep.
• Peripheral Neuropathy – numbness, burning sensation (often in
diabetes).
• Stroke – increased risk due to vascular degeneration.
• 2. 💓 Cardiovascular System
• Hypertension – very common in elderly.
• Atherosclerosis – narrowed arteries, risk of heart attack/stroke.
• Heart Failure – fatigue, breathlessness, edema.
• Arrhythmias – atrial fibrillation, bradycardia.
• Orthostatic Hypotension – dizziness due to blood pressure drop on standing.
• 3. 🧠 Respiratory System
• Reduced Lung Capacity – breathlessness during exertion.
• Chronic Obstructive Pulmonary Disease (COPD) – especially in smokers.
• Pneumonia – increased risk due to weak immunity.
• Sleep Apnea – pauses in breathing during sleep.
• 4. 🧠 Gastrointestinal System
• Constipation – reduced gut motility and fluid intake.
• Gastroesophageal Reflux Disease (GERD) – heartburn, indigestion.
• Malnutrition – due to poor appetite, dental problems.
• Liver Function Decline – slower drug metabolism.
• 5. 🚻 Genitourinary System
• Urinary Incontinence – stress or urge incontinence.
• Benign Prostatic Hyperplasia (BPH) – in elderly men.
• Chronic Kidney Disease – declining renal function.
• Urinary Tract Infections (UTIs) – recurrent in older women.
• 6. 🧠 Musculoskeletal System
• Osteoarthritis – joint pain, stiffness, reduced mobility.
• Osteoporosis – fragile bones, high fracture risk (e.g., hip fractures).
• Sarcopenia – age-related muscle loss and weakness.
• Postural Changes – kyphosis, reduced height.
• 7. 🧠 Endocrine System
• Type 2 Diabetes Mellitus – common with age.
• Thyroid Disorders – hypothyroidism is more prevalent.
• Menopause/Andropause – hormonal changes affecting bones and mood.
• 8. 🧠 Integumentary System (Skin, Hair, Nails)
• Dry Skin – prone to itching and tears.
• Pressure Ulcers – from immobility and poor circulation.
• Delayed Wound Healing – increased infection risk.
• Hair Thinning, Nail Brittleness – cosmetic and health impact.
• 9. 🧠 🧠 Sensory Systems
• Vision Loss – cataracts, glaucoma, macular degeneration.
• Hearing Loss (Presbycusis) – difficulty in communication.
• Impaired Taste and Smell – reduced appetite and safety risks.
• 10. 🧠 Psychosocial & Mental Health
• Depression and Anxiety – often underdiagnosed.
• Social Isolation – due to retirement, bereavement.
• Elder Abuse – physical, emotional, financial neglect.
• Cognitive Impairment – impacts decision-making and independence.
UN (1991) PRINCIPLE FOR OLDER
PERSON
• 1. Independence
• 2. Participation
• 3. Care
• 4. Self-fulfilment
• 5. Dignity
• 1️⃣ Independence
• Older persons should have the right to live independently and make
choices about their lives.
• Key Points:
• Access to adequate food, water, shelter, and clothing through
income, family, or government support.
• Opportunity to work or access income-generating opportunities.
• Ability to make decisions about their retirement and lifestyle.
• Access to healthcare and support services that enable aging in place
(in their homes or communities).
• Freedom to reside at home for as long as possible, rather than being
institutionalized.
• 2️⃣ Participation
• Older persons should actively participate in society and in decisions that
affect their lives.
• Key Points:
• Inclusion in policy and program development at local, national, and
international levels.
• Opportunities for community service, volunteering, and civic engagement.
• Participation in intergenerational activities to foster connection and
respect.
• Encouragement to share their knowledge, skills, and experience for the
benefit of society.
• Access to cultural, educational, and social events.
• 3️⃣ Care
• Older persons should have access to care and protection, especially in
times of illness or dependency.
• Key Points:
• Access to healthcare, rehabilitation, and social support services.
• Provision of appropriate institutional or home-based care for those
who need it.
• Promotion of family and community-based care options.
• Ensuring legal protection from abuse, neglect, and exploitation.
• Access to physical and mental health services tailored to geriatric
needs.
• 4️⃣ Self-Fulfilment
• Older persons should be able to pursue opportunities for personal
growth and fulfillment.
• Key Points:
• Access to educational, cultural, spiritual, and recreational
resources.
• Encouragement to explore personal interests, hobbies, or lifelong
learning.
• Promotion of creativity, autonomy, and continued productivity.
• Support for maintaining a sense of purpose and contribution to
society.
• Respect for their aspirations and abilities to achieve personal goals.
• 5️⃣ Dignity
• Older persons should live in conditions of dignity and security, free
from exploitation and discrimination.
• Key Points:
• Protection from ageism, neglect, and violence.
• Respect for their autonomy, preferences, and personal values.
• Equal access to justice, resources, and opportunities.
• Recognition of older persons as valued members of society, not as
burdens.
• Assurance of safe, respectful, and compassionate care.
PRIMORDIAL PREVENTION
• Health Education:
• 1. Explaining the biological changes in ageing
• 2. Personal hygiene
• 3. Regarding smoking, alcohol related diseases
• 4. Information on Communicable/ Non-communicable disease specific to
old age
• 5. Availability and utility of health services
• 6. Use of aids like visual, auditory, walking aids, etc
• 7. Information regarding elderly abuse
• 8. Over the counter drugs (drugs that you can buy without a prescription to
relieve aches, pains)
• COMMUNICABLE DISEASE IN ELDERLY: Pneumonia,
Tuberculosis, Influenza, Urinary Tract Infections (UTIs), COVID-19,
Herpes Zoster
• NON-COMMUNICABLE DISEASES (NCDs) IN ELDERLY:
Hypertension, Type Diabetes Mellitus, Osteoarthritis, Alzheimer’s
disease, Osteoporosis, Heart disease (Ischemic Heart Disease,
Congestive Heart Failure), COPD, Cancer
PRIMARY PREVENTION
• Environmental Modification:
• 1. Maintenance of clean housing condition
• 2. Need for fresh air, light and ventilation
• 3. Disposal of waste and human excreta
• 4. Vector control
• Nutritional Intervention:
• 1. Principles of balanced diet
• 2. Food safety
• 3. Food which improve bowel movement
• Prevention of Accidents Both Inside/ Outside the Home
• 1. Slip resistant flooring
• 2. Smooth pathways
• 3. Hand rails in bathrooms
• 4. Stairs- landing at short intervals
• 5. Adequate lighting
• 6. Contrasting colors
• Lifestyle & Behavioral Changes
• 1. Physical exercises like yoga and relaxation
• 2. Personal habits like alcohol, smoking and tobacco chewing
SECONDARY PREVENTION
• SPECIFIC PROTECTION:
• Immunization
• Avoidance of injuries and falls
• Vitamin D, calcium supplementation
• Certain food rich with antioxidant property- protect against cancer and
degenerative disorders
• EARLY DIAGNOSIS & TREATMENT
• Early recognition of CD and NCD, proper treatment, patient compliance
and self care
• Provision of free medical care
TERTIARY PREVENTION
• Tertiary prevention in elderly care focuses on managing existing
health conditions, preventing complications, and improving quality of
life.
• GOAL: To restore function, reduce suffering, and support
independent, dignified aging, even in the presence of chronic illness
or disability.
1. Rehabilitation after stroke, fractures, or surgery to restore mobility
and function.
2. Chronic disease management (e.g., diabetes, hypertension) to avoid
complications.
3. Fall prevention through home safety modifications and balance
exercises.
4. Mental health support for dementia, depression, and social isolation.
5. Pain and symptom control in chronic and terminal conditions.
6. Palliative care to ensure comfort and dignity in advanced illness.
7. Assistive devices to enhance independence and safety.
8. Caregiver education to improve at-home care and reduce
readmissions.
THANK YOU
